Effect of Counseling Based on the EX-PLISSIT Model on the Sexual Satisfaction of Couples during Pregnancy: A Randomized Controlled Trial

Introduction: Pregnancy and childbirth are distinct periods in a woman's life that involve significant hormonal and physical changes. These changes can impact sexual satisfaction for both partners. The present study aimed to evaluate the effect of couple-centered counseling, based on the EX-PLISSIT model, on the sexual satisfaction of couples during pregnancy in comprehensive health centers in Hamadan city in 2021. Methods: A randomized controlled trial was conducted in Hamadan city in 2021, involving 30 couples. The sample size was estimated based on information from previous studies and divided into two groups. Participants were assigned to either the intervention or control group using a randomized block design. The intervention group received four weekly counseling sessions based on the EX-PLISSIT model, with one face-to-face session per week for each couple. The control group received routine antenatal care in accordance with local guidelines. Sexual satisfaction was assessed using Linda Berg's Sexual Satisfaction Scale. Data analysis was performed using Stata version 13, including descriptive statistics and inferential tests, such as paired t-tests, independent t-tests, and ANCOVA. The significance level for all statistical tests was set at p < 0.05. Results: ANCOVA results, controlling for duration of marriage and pre-intervention scores, showed that the mean (SD) sexual satisfaction score in women was 57.21 (2.18) in the intervention group and 54.81 (2.18) in the control group, indicating a statistically significant difference (Cohen’s d = 1.24; 95% CI: 0.69–1.79; p < 0.001). In men, after adjusting for the same variables, the mean (SD) sexual satisfaction score was 60.95 (1.56) in the intervention group and 59.55 (1.56) in the control group, also showing a significant difference (Cohen’s d = 0.89; 95% CI: 0.36–1.42; p = 0.001). Conclusion: The findings of this study suggest that EX-PLISSIT-based counseling has a positive effect on couples' sexual satisfaction during pregnancy. Implementing this counseling model may be recommended as a strategy to enhance sexual satisfaction in expectant couples.